Thursday, July 23, 2009

I hate my junkies. I don't have many. Every doc has at least a few, and you just learn to deal with them. Some you created by accident (though your original intentions were good) and some you inherited from some other neurologist who had the audacity to die, retire, or move.

What drives me nuts, though, are the ones who come in that way, and try to play you from the word go. And today I had one.

He came in, and after listening to his pathetic story (complete with violin music) I ordered an MRI. He said he was claustrophobic, so I gave him a script for 2 Valium tablets.

After the appointment he walked out to the check-out desk, which is roughly 20 feet from my office. He then told my secretary that he'd lost the Valium script while walking up front, and could she write him a new one (last I checked, my staff ain't allowed to issue scripts for controlled substances).

So she said she'd go look for it, whereupon he suddenly "discovered" it was in his shirt pocket the whole time. Bozo. So he went on his way.

Within an hour Local Pharmacy had called me to query the script. The one that he brought to them was for 200 Valium tablets, not the 2 I'd written for. And was altered in a different ink color.

15 comments:

Anonymous
said...

These twits are the ultimate "method" actors, except nobody believes their crap but them. In Northern Calif. we are experiencing an ongoing glut of tweakers who are so vastly superior in intellect to normal, non-chemically augmented people that they don't need jobs, homes or personal hygiene. Stealing, living in a car and reeking is, to them a sign of their transcendence. Fortunately the long-term effects of Meth allows them to transcend living all the sooner. Pity, that.

My wife's stories from when she was an X-ray tech included drug seekers who would injure themselves in order to get pain meds. One that I recall punched a wall. When my wife's x-ray revealed no fracture, he got mad and told her she didn't do it right.

Ironically, my wife now needs meds to control chronic pain. Getting prescriptions for potent meds is difficult because of the safe guards put in place to deter drug seekers.

The best idiots are the ones who bring into the pharmacy scripts written or altered in crayon, some how I really doubt they stole or got the script from was using the big box of crayola when writing scripts that day. You also have to wonder how many brain cells are left when they think they can change a script for 5 percocets into 500 from an ER doc or try changing #20 oxycontin of Xmg into #2000.

If more doctors would hold the line on these guys, they'd themselves have fewer headaches. It's my opinion that the junkies take up a hugely disproportionate amount of your time for two reasons. The first is that they constantly find elaborate ways of getting their drugs, and this occurs several times per month or week, with much drama that escalates over time. The second is, there is always something else going on psychologically that will not be satiated long term with any substance. Not even the new one that's on TV now. Perfect example is the FMS narcotic addict or the migraine Fiorinal/diazepam/CII addict who will e-mail or phone you several times a week or day, always requiring a time-sucking response.

I tell doctors there are tricks to avoid these people, ensuring they'll find another doctor who is a sucker and leave you alone to spend time with real medical cases. You know, unless you like the psychology with the emotionally labor-intensive patients. For some docs, that is their forte. Otherwise, if I were a physician, I would let patients know right off the bat--I don't honor requests for brand-named controlled substances EVER. That will take care of at least a third to a half of your drug-seekers. Let them know you'll require an office visit to replace lost or stolen prescriptions. There goes another fourth of these folks.

How dumb do they think us pharmacists are? 200 valium tabs? In different ink? ROFLMAO. Reminds me of the time I got a pcn rx from a dds office...written in the corner of the prescription in teeny tiny writing was a vicodin rx. Please...she swore to the cops the dds had written it. Which of course he hadn't.

The last time I was used for 'scripts, I almost reported to the police. Per our police, that is OK (and doesn't violate patient/doctor privilege...per the police). I didn't but they are being criminal when they do this. Your thoughts?

The frightening thing....the number of times a pharmacist catches this vs. the number of times they are successful. Not all of them are that dumb....I hate to think about it.

Just let me say, I rarely take anything at all, motrin, tylenol...that's about it. soooI had an ER visit a few months back. the ER doc prescribed oxycontin 5mg #10...after having surgery (minor)..my surgeon prescribed the same meds and dose , but #50...really. I disposed 8 from the first 10. shredded the script from the second, script. I knew it was up to me to take control...had I not done that who knows>>>>>>>> Sorry but I really just didn't like the way they made me feel...

@Anonymous, thank you for mentioning the BRAND narc issue. I love to see profiles where a patient will take generics for BP and diabetes but suddenly are allergic to generic when it comes to pain killers.

When I worked in a pharmacy as a tech, when we got a phony or altered Prescription, one of my favorite pharmacists would have me trot out to the candy aisle and get a bag of whichever candy closest approximated the narcotic prescription that was falsified i.e., hydrocodone/APAP = M&M peanut, diazepam = Smarties. We'd make dummy lables, dispense candy, and charge the jerk regular price. Then we would order pizza with their $$$.

It seems so easy to blame these 'addicts' when in reality getting drug treatment is very hard to get and this is coming from a recovering pill addict who is on SSI and has medicaid but still has to pay $430 a month out of pocket for drug treatment that isnt covered...and I also use to "fix" the post dates on my scripts and didnt get caught for almost a year, I'm very ashamed as that person wasnt me, addiction turns us into monsters, it's very scary. But one year clean this week. YAY

I had hoped that this kind of bullshit became less of a problem when we switched to EMR and e-scripting. Unfortunately, the program won't e-script controlled substances! Why, oh why? For fear of fraud?! Yeah, paper is much more secure.

Welcome to my whining!

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